Prognostic Impact of Inflammation-based Scores on Thymic Carcinoma or Thymic Neuroendocrine Tumor: a Single-center Experience

Masahiro Yanagiya, Keita Nakao, Kentaro Kitano, Kazuhiro Nagayama, Jun-ichi Nitadori, Masaki Anraku, Masaaki Sato, Jun Nakajima

The University of Tokyo Graduate School of Medicine, Tokyo, Japan

Date, time and location: 2018.05.25 15:30, Congress Hall, 2F–C

Abstract

OBJECTIVE: Preoperative inflammation-based scores such as peripheral neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (NLR), fibrinogen (Fib) and Glasgow prognostic score (GPS) have been reported as predictors of prognosis of various cancers. The aim of this study was to investigate the impact of inflammation-based scores on postoperative prognosis of thymic carcinoma (TC) or thymic neuroendocrine tumor (TNET).

PATIENTS AND METHODS: Retrospective review of patients who underwent surgical resection for TC or TNET (N=32, 01/1984-3/2017). Exclusion criteria: surgery for recurrence and missing data. Preoperative NLR, PLR, serum albumin (Alb), C-reactive protein (CRP) and Fib were measured within 3 weeks just before surgery. We used the median value as the optimal cut-off value for NLR, PLR and Fib (2.50, 160 and 330), respectively. We adopted adjusted GPS (a-GPS) calculated based on cut-off values 0.3 mg/dl for CRP and 3.9 g/dl for Alb. We evaluated overall survival (OS), progression-free survival (PFS) and cumulative incidence of progression (CIP) using Kaplan-Meier method and the log-rank test. Multivariate analyses were assessed by the Cox proportional hazards model and Fine-Gray proportional hazards model.

RESULTS:Twenty eight patients were included in this analysis. The OS and PFS, CIP were significantly worse in the patients with high PLR than those with low PLR (p < 0.05). The OS was significantly worse in the patients with high Fib than those with low Fib (p < 0.05). The 5-year OS rates were 78, 39 and 25% with a-GPS 0, 1 and 2 (1 vs 0: p < 0.05; 2 vs 1: p=0.67; 2 vs 0: p < 0.01), respectively. On multivariate analyses for PFS and CIP, high PLR and 8th TNM stage III/IV were independently associated with poor outcome.

CONCLUSION: Preoperative PLR may be a useful biomarker to predict postoperative prognosis of TC or TNET.